Insurance Eligibility & Verification Specialist

Experience: 1–3 Years

Shift: US/Night Shift

Industry: US Healthcare / RCM

Job Summary

We are looking for an Insurance Eligibility & Verification Specialist with 1–3 years of experience in US Healthcare RCM. The candidate should have hands-on experience in demographics verification, insurance eligibility and benefits verification, payer portals, and basic charge entry.

Key Responsibilities

- Verify patient demographics, insurance eligibility, and advantages.
- Check copay, deductible, coinsurance, and out-of-pocket maximums.
- Verify insurance coverage through payer portals and insurance websites.
- Handle Medicare, Medicaid, and Commercial Insurance verification.
- Check prior authorization and referral requirements for physician/provider services.
- Review patient and insurance information before charge posting.
- Perform charge entry and charge capture using CPT/HCPCS and diagnosis codes.
- Verify DOS, provider, place of service, insurance details, modifiers, and units.
- Identify missing or incorrect information and coordinate for corrections.




- Maintain accurate verification and charge-related documentation.
- Support clean claim submission and help prevent eligibility and charge-related denials.
- Follow HIPAA and patient confidentiality requirements.

Required Skills
- 1–3 years of experience in US Healthcare RCM / Insurance Verification / Eligibility.
- Strong knowledge of insurance eligibility and benefits verification.
- Experience with Medicare, Medicaid, and Commercial Insurance.
- Experience using payer portals such as Availity and UHC.
- Knowledge of CPT/HCPCS, diagnosis codes, DOS, POS, modifiers, and units.
- Basic understanding of physician/provider billing and charge entry.
- Good communication, analytical, and documentation skills.
- Ability to meet productivity and quality targets.
- Willingness to work in US/night shifts.

Pay: ₹20,000.00 - ₹40,000.00 per month

Benefits

- Leave encashment
- Paid sick time

Work Location: In person

📌 Insurance Verification & Physician Services Executive. (Mandaveli)
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📍 Mandaveli